Don’t pigeonhole mental illness: ‘It’s about human emotions’

Don’t pigeonhole mental illness: ‘It’s about human emotions’
Don’t pigeonhole mental illness: ‘It’s about human emotions’

‘Good luck’, said a talk show host at the end of the conversation with Hanna and her brother Juda Verboom. They sat there, together with professor of psychiatry Jim van Os, to talk about the taboo on mental illness.

Fighting stigma

The moment it happened, Hanna nodded kindly. But when she looked back at the interview, she really heard what was being said. Exactly that one word, no matter how well-intentioned, confirmed that there is still a stigma. “That you’re not doing well if you have a psychic variation,” she says. “The stigma that ensures that millions of Dutch people do not dare to talk about their psychological variations.”

She didn’t do that herself either, for no less than twenty years. Around her 20th birthday, Hanna was diagnosed with bipolar disorder, also known as manic-depressive disorder. This means that your mood alternates between manic periods (high energy, feeling like you can handle the world), depressive periods (gloomy and insecure, low energy) and normal periods.

Hanna was told at the time that she should never say anything about this. She would never return to work.

‘Together from the shadows’

In her recently released documentary ‘Together from the shadow’ on the Dutch streaming service Cinetree, she goes against that stigma. Together with her brother Juda, she tries to find answers to questions such as: why do so many Dutch people struggle with their mental health? And why is this still a taboo?

Recent research by the Trimbos Institute shows that a growing group of Dutch people are struggling with psychological problems. For example, last year one in four Dutch people met the criteria for a mental disorder, such as an anxiety disorder, depression or problematic alcohol or drug use. It is mainly young adults and students who experience difficulties.

The stigma that something is wrong with you when you struggle with your mental health is one of the reasons people are afraid to talk about it. And that’s partly because people with a mental illness are put in a box, says Hanna. Her message is therefore: “Please let’s talk about variations and not about disorders. About vulnerabilities instead of diseases. About the strength of people with psychological variation and not just about their vulnerability.”

Scientifically outdated

Jim van Os, professor of psychiatry at UMC Utrecht, says that the concept of variation is very important. “Since the 1980s, we’ve been working with the so-called bible of psychiatry, also known as the Diagnostic and Statistical Manual of Mental Disorders (DSM),” he says. “It contains a few hundred syndromes with associated criteria.”

But that Bible is scientifically outdated. “Fifty years of intensive research have never been able to show that you can neatly classify psychological suffering. What has been shown is that psychological suffering is essentially about ordinary human emotions in response to the environment.”

He compares it to having an extremely low IQ. According to Van Os, you could see that as a variation of a cognitive skill that we all have, just as the most severe psychosis or anxiety is also a variation of ordinary human worries and fears that we all have.

That does not alter the fact that you can be deathly ill from a severe psychosis. But being ill is different from having a disorder, Van Os emphasizes. “You don’t have to say it’s a disorder to call it a disease.”

Pushed into a corner

So it is precisely in its appointment that it goes wrong. Van Os: “If you say: you have schizophrenia or borderline, you push people into a corner. You push them at a distance. And that affects the identity of the person involved.”

Those people write themselves off and adopt the idea that they are different. “And that leads to all sorts of misery,” he says. “Instead you can also say: you have a certain degree of mood sensitivity, without that stamp. Then you give a different message: you belong to the human spectrum.”

Talk, talk, talk

It would just be one of the reasons that people do not want to talk easily about their ‘psychological variation’ or ‘psychological vulnerability’. While it is precisely that talking that is ‘of vital importance’. “To normalize it,” says Hanna, referring to the percentage of Dutch people (48 percent) who have ever had a mental illness. “If you know you’re not alone, it’s easier to ask for help and you don’t have to isolate yourself from the rest out of shame.”

In addition, it is also important to talk to each other, because you learn from each other. “The more we are open and normalize ‘psychic variations,’ the more we can also talk about someone’s strength and what someone is good at.”

Language and stigmas

So it is important to use language that does not confirm the stigmas, also known as ‘destigmatizing’ language. Communication advisor Jessica Rits, together with Judith de Laat, gives training courses in ‘people-oriented language about mental health’. Rits emphasizes that no one consciously wants to exclude someone through language. “It often happens subconsciously.”

Often a stigma can be prevented by choice of words. An example is when a text mentions people with a psychological vulnerability and then refers to ‘these people’. “Then you create a strong distinction between us and them,” she says. How do you best prevent this? “By speaking again about people with psychological vulnerability. Then you keep it more neutral. Otherwise you dismiss a group as different.”

In addition to using neutral frames, Rits has a number of tips when it comes to destigmatizing language. “A DSM label doesn’t always help,” she says. “You don’t have to talk about ‘all persons with autism’, because everyone is unique.” You also have to be careful with denials, she says. “In a sentence: people with depression are not lazy, our brain only reads ‘depression’ and ‘lazy’.”

The article is in Dutch

Tags: Dont pigeonhole mental illness human emotions